Incidence and significance of gasping or agonal respirations in cardiac arrest patients

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Purpose of review

This review examines the clinical significance of agonal respirations associated with cardiac arrest.

Recent findings

Observational data indicate that agonal respirations are frequent (55% of witnessed cardiac arrests and probably higher) and that they are associated with successful resuscitation. They also are found more commonly in ventricular fibrillation compared with other rhythms. Agonal respirations pose the greatest challenge to bystanders at the scene and to emergency dispatchers. Bystanders are often lulled into thinking the person is still breathing thus identification of cardiac arrest may be missed by the dispatcher. In a study from King County, Washington, cardiopulmonary resuscitation instructions were not provided by emergency dispatchers in 20% of cardiac arrest cases because the caller reported signs of life – typically abnormal breathing.


Agonal respirations occur frequently in cardiac arrest. Emergency dispatchers and the general public must be more aware of their presence and significance.

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